MyAccess Sign In

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

INTRODUCTION AND EPIDEMIOLOGY

The thought of a woman presenting to the ED in active labor is justifiably a cause for anxiety—the emergency physician must contend not only with the often rusty recollection of the stages of normal delivery, but also with the knowledge that there are serious and even fatal complications associated with labor. Maternal and fetal survival may depend on the ability to successfully manage pre-eclampsia, eclampsia, hemorrhage, shoulder dystocia, malpresentation, cord prolapse, breech delivery, or fetal distress. Every ED should be prepared to take care of a woman in active labor. Tools include a basic delivery kit, an infant warmer or isolate, and medical supplies and equipment for neonatal resuscitation (see chapter 108, "Resuscitation of Neonates" and Tables 101-1 and 101-2).

Out-of-hospital births occurred in 1.36% of births in 2012, and out-of-hospital births in the United States had a lower risk profile than in-hospital births, so that fewer teen, preterm, low-birth-weight, ...